Providing Treatment for India’s Poor Mothers

Pregnant women waited for a check-up at a maternity ward in a public hospital in Nawanshahr, Punjab, July 5.

For Rehana Khattun, a 28-year-old from Hyderabad’s busy Bowenpally area, having her third child was a matter of little worry until she was told about her high blood pressure.

High blood pressure leaves pregnant women susceptible to preterm deliveries of underweight babies, as well as preeclampsia, which can adversely affect the mother’s kidneys, liver and brain.

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Ms. Khattun was about eight months pregnant when her local government hospital doctor warned her about her condition. She met community outreach workers from LifeSpring Hospitals who were campaigning for better maternal health and treatment in the area. She says they helped her get specialized attention, medicine to stabilize her blood pressure, and counseling on her diet.

Both Ms. Khattun and her baby turned out healthy. That’s not always the case.

India’s maternal mortality statistics are grim. The United Nation’s Millennium Development Goals Report of the U.N. Secretary-General 2012 pegged the maternal mortality rate of the country at 212 per 100,000 live births.

LifeSpring Hospitals, which opened in 2005 in Hyderabad, hopes to help improve these numbers. It has grown into a chain of small hospitals — typically with 20 to 30 beds each – that cater primarily to low-income pregnant women. The hospitals are mostly situated near slums, ensuring low real estate costs and high footfall rates.

At LifeSpring, a regular delivery costs 4,000 rupees ($70), while a cesarean section can be done for 9,000 rupees. The regular delivery is a lot more expensive than at a government hospital such as Delhi’s All India Institute of Medical Sciences, which charges about 2,000 rupees.

“But most government hospitals are poorly run where patients often have to pay bribes to ensure basic care. Often they are at the mercy of the ward staff,” says Anant Kumar, the founder and chief executive of LifeSpring Hospitals.

“The entrance hall of every LifeSpring hospital has a list of the procedures with costs clearly mentioned. Here, a patient doesn’t have to pay anything extra. The costs mentioned cover everything, including medicines,” he says.

By focusing on maternal care, the hospital chain standardizes clinical procedures and medicine kits, further bringing down costs. “We didn’t get very sophisticated machines because those are expensive and force hospitals to make up costs from the patients,” explains Mr. Kumar. None of the LifeSpring hospitals have intensive care units.

“We learnt from the example of low cost airlines. We keep our volumes high and gradually the services pay for themselves. We do work out a margin for ourselves but we are in no hurry make a profit,” says Mr. Kumar.

Unexpected emergency cases that can’t be handled at LifeSpring are sent to nearby partner hospitals. LifeSpring patients get access to the partner hospitals’ facilities but pay LifeSpring at the charges fixed.

“These partnerships are usually with trust or NGO-run hospitals where the rates are much lower than corporate hospitals,” says Mr. Kumar. “We usually work with the Andhra Mahila Sabha hospitals, run by a charitable trust.”

In roughly five years, the chain has grown to 12 hospitals located in densely populated low-income areas in Hyderabad. The first unit, set up at Moula Ali, broke even in two years. Yet LifeSpring is still too expensive for many.

“Government hospitals fill a crucial gap but often due to the lack of doctors and educated personnel, crucial resources are stretched thin, making services extremely poor,” says Mr. Kumar.

LifeSpring is a 50-50 joint venture between the public sector contraceptive maker HLL Lifecare (formerly Hindustan Latex Limited) and New York-based private social investor Acumen Fund.

To ensure a better understanding of the needs of expectant mothers, Mr. Kumar trained midwives to assist as community outreach workers. Tricia Morente, an Acumen Fund fellow who stayed on as head of marketing and strategy, creates a method of feedback that helps the hospital improve its services. “We wanted a more personal view of their experience so our community health workers would visit homes and talk to our customers.”

Mr. Kumar admits the LifeSpring model still needs fine tuning. “Our reach is very limited,” he says. “We are growing but it’s all in Hyderabad. Finding the right kind of social investor is hard [and] this affects the quality of maternal care in the country. Can we afford that?”

Paromita Pain, a graduate from the Annenberg School of Journalism at the University of Southern California, writes on development-based issues in India and the U.S.

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